Zhao Ziqian, Xu Haoyi, Ma Binlin, Dong Chao
The Clinical Medical Research Center of Breast and Thyroid Tumor in Xinjiang, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi, China.
Front Immunol. 2025 Aug 20;16:1658571. doi: 10.3389/fimmu.2025.1658571. eCollection 2025.
The platelet to lymphocyte ratio(PLR) is widely recognized as an important biomarker of systemic inflammation and has been associated with treatment responses in breast cancer (BC) patients undergoing neoadjuvant therapy. However, existing evidence remains inconsistent. This meta-analysis aims to systematically investigate the prognostic value of PLR in BC patients receiving neoadjuvant chemotherapy (NACT).
A broad and systematic search of the literature was carried out using PubMed, Embase, Web of Science, and the Cochrane Library, covering all available records from the inception of each database through April 7, 2025. Study selection was guided by a set of predetermined inclusion and exclusion parameters. Primary outcomes included overall survival (OS), disease-free survival (DFS), and pathological complete response (pCR), assessed through hazard ratios (HRs) or odds ratios (ORs) with corresponding 95% confidence intervals (CIs).
Twenty-four studies involving 7,557 BC patients receiving NACT were included. Elevated PLR was significantly associated with reduced pCR rates (HR = 1.51; 95% CI: 1.24-1.84; p < 0.0001; I² = 70%), shorter OS (HR = 1.64; 95% CI: 1.27-2.11; p = 0.0002; I² = 0%), and decreased DFS (HR = 2.29; 95% CI: 1.54-3.39; p < 0.0001; I² = 44%). Subgroup analyses indicated that PLR's prognostic value varied by timing of PLR measurement, geographic location, and PLR cutoff values.
Elevated PLR is significantly correlated with poorer clinical outcomes in BC patients undergoing NACT, suggesting its potential as a predictive biomarker for treatment efficacy. However, due to methodological limitations of the included studies, further prospective investigations are required to confirm these findings across diverse populations.
https://www.crd.york.ac.uk/prospero/, identifier CRD420251064051.
血小板与淋巴细胞比值（PLR）被广泛认为是全身炎症的重要生物标志物，并且与接受新辅助治疗的乳腺癌（BC）患者的治疗反应相关。然而，现有证据仍不一致。本荟萃分析旨在系统研究PLR在接受新辅助化疗（NACT）的BC患者中的预后价值。
使用PubMed、Embase、Web of Science和Cochrane图书馆对文献进行广泛而系统的检索，涵盖每个数据库自创建以来至2025年4月7日的所有可用记录。研究选择以一组预先确定的纳入和排除标准为指导。主要结局包括总生存期（OS）、无病生存期（DFS）和病理完全缓解（pCR），通过风险比（HR）或比值比（OR）及相应的95%置信区间（CI）进行评估。
纳入了24项涉及7557例接受NACT的BC患者的研究。PLR升高与pCR率降低显著相关（HR = 1.51；95% CI：1.24 - 1.84；p < 0.0001；I² = 70%）、OS缩短（HR = 1.64；95% CI：1.27 - 2.11；p = 0.0002；I² = 0%）以及DFS降低（HR = 2.29；95% CI：1.54 - 3.39；p < 0.0001；I² = 44%）。亚组分析表明，PLR的预后价值因PLR测量时间、地理位置和PLR临界值而异。
PLR升高与接受NACT的BC患者较差的临床结局显著相关，表明其作为治疗疗效预测生物标志物的潜力。然而，由于纳入研究的方法学局限性，需要进一步的前瞻性研究以在不同人群中证实这些发现。
